Diagnosing and Treating GERD

If you are like most Americans, you have experienced that burning feeling you get when you have heartburn. But when those symptoms persist, you have Gastroesophageal Reflux Disease (GERD).

So what is GERD?

Often referred to as acid reflux, gastroesophageal reflux disease (GERD) occurs when stomach acid frequently flows back into the esophagus. When this backwash (acid reflux) touches the lining of the esophagus it causes a burning feeling.

Symptoms of GERD

Some of the symptoms you may experience when you have GERD include the following:

Sore Throat

Hoarseness

Lump in your throat

Feeling of food sticking

Nausea

Belching

Cough

Severe Symptoms

If you have any of the following symptoms, you need to see a doctor IMMEDIATELY.

Experiencing chest pain with activity

Choking on your food

Losing weight without trying

Throwing up blood or coffee grounds

Having red or black stools

3 Tips to Find Relief from GERD Symptoms

The following are some tips to help you get relief from your GERD symptoms.

#1 – Follow an anti-reflux diet.

Avoid these foods:

Spicy

Acidic

Fatty/Rich

Coffee

Wine

Chocolate

Mint

#2 – Avoid food or drink before lying down.

Don’t eat or drink for at least three hours before lying down.

#3 – Lose weight.

Losing 5-10 pounds can help ease symptoms.

Treatment Options for GERD

Histamine H2-receptor antagonists “H2 Blockers”

H2 blockers are medications that include Ranitidine (Zantac), famotidine (Pepcid AC). They should be used on occasion, not long-term, because the body can build resistance to them.

Proton Pump Inhibitors (PPIs)

For more persistent and long-term symptoms, Proton Pump Inhibitors (PPIs) are typically used.

PPIs must be prescribed by physicians and include Esomeprazole (Nexium), Omeprazole (Prilosec), and pantoprazole (Protonix). They should be taken 30 minutes to 1 hour before eating to be effective. It is recommended that you take the lowest dose possible.

PPIs are safe, even though recent headlines have linked PPIs with kidney disease, heart attack/stroke, dementia, and hip fractures. The studies are flawed. People with symptomatic GERD should be on a PPI, and should take the lowest effective dose. Try an over-the-counter (OTC) dose for two weeks to start.

Progression/Risks

If GERD continues for an extended period of time, it can cause scar tissue. The body creates a ring-shaped scar tissue barrier to protect the esophagus from acid splashing up, and this can cause food to get stuck.

Barrett’s Esophagus

Barrett’s Esophagus is when normal esophageal cells start changing their identity, which can end in cancer if not monitored by your physician.

The risk to develop Barrett’s Esophagus is extremely low, at 0.25-0.5 percent each year for developing it. This means that if you are 50 years old, by the time you are 90 your risk for developing esophageal cancer will be 10-20 percent. Your risk for other things such as a heart attack or even dying in your sleep will be much higher.

Esophageal Cancer

While this is not very common, esophageal cancer can develop in those with persistent GERD. Elderly men are most at-risk.

GERD is common, with more than half of Americans experiencing heartburn at any time.

To help ease symptoms of GERD, lose weight and follow the anti-reflux diet. If needed, use the PPIs, and always use the lowest effective dose. And don’t worry too much unless there are alarming symptoms. In that case, see a physician immediately.

About Shannon Scholl, MD

Dr. Shannon Scholl is a board certified gastroenterologist who practices out of the Women’s Center for GI Health in Cary, NC.